Darko Jekauc

Long-term health benefits of physical activity – a systematic review of longitudinal studies

BackgroundThe treatment of noncommunicable diseases (NCD), like coronary heart disease or type 2 diabetes mellitus, causes rising costs for the health system. Physical activity is supposed to reduce the risk for these diseases. Results of cross-sectional studies showed that physical activity is associated with better health, and that physical activity could prevent the development of these diseases. The purpose of this review is to summarize existing evidence for the long-term (>5 years) relationship between physical activity and weight gain, obesity, coronary heart disease, type 2 diabetes mellitus, Alzheimer’s disease and dementia.MethodsFifteen longitudinal studies with at least 5-year follow up times and a total of 288,724 subjects (>500 participants in each study), aged between 18 and 85 years, were identified using digital databases. Only studies published in English, about healthy adults at baseline, intentional physical activity and the listed NCDs were included.ResultsThe results of these studies show that physical activity appears to have a positive long-term influence on all selected diseases.ConclusionsThis review revealed a paucity of long-term studies on the relationship between physical activity and the incidence of NCD.

Prevalence and socio-demographic correlates of the compliance with the physical activity guidelines in children and adolescents in Germany

BackgroundRegular physical activity (PA) is a prerequisite for normal growth and maturation, health, and fitness of children and adolescents. Because of the growing evidence of the health benefits of regular PA, several national and international public health organisations have established PA guidelines. The purpose of this study was to assess the percentage of children and adolescents in Germany who meet the PA guideline of 60 minutes of moderate-to-vigorous PA each day and to evaluate socio-demographic correlates of compliance with the PA guideline.MethodsThe sample consists of 4,529 children and adolescents aged between 4 and 17 years who lived and were registered in the Federal Republic of Germany between 2003 and 2006. The compliance with the PA guideline was assessed using a widely accepted screening measure. Socioeconomic status, immigration background and residential area were assessed using a parent questionnaire.ResultsOverall, 13.1% of girls and 17.4% of boys complied with the national guideline of 60 minutes of moderate-to-vigorous PA daily. While compliance was significantly lower in older participants of both gender groups, the steepest decrease in compliance was observed for age groups around the transition time from primary to secondary school. Logistic regression revealed that socioeconomic status and a migration background were significant predictors for compliance in girls and residential area for compliance in boys.ConclusionsPrograms and policy action addressing the problem of decreasing compliance with PA guideline with increasing age are warranted. The transition from primary school to secondary school seems to be a critical stage in life with respect to PA behaviour. Therefore, specific interventions should aim at restructuring and reorganising their daily and physical activities during this transition.

Peer Problems Mediate the Relationship between Developmental Coordination Disorder and Behavioral Problems in School-Aged Children.

The aim of this study was to gain insights into the relationship between developmental coordination disorder, peer problems, and behavioral problems in school-aged children where both internalizing and externalizing behavioral problems were considered. We assumed that the relationship between developmental coordination disorder and internalizing/externalizing problems in school-aged children is mediated by peer problems and tested the hypothesis that a greater degree of motor impairment causes a greater degree of peer problems and thus a greater degree of internalizing or externalizing problems. Seventy boys and girls aged between 5 and 11 years were examined using the Movement Assessment Battery for Children 2 and the Intelligence and Developmental Scales. The results of path analysis showed that the relationship between developmental coordination disorder and internalizing/externalizing problems in school-aged children is mediated at least in part by peer problems. However, the cross-sectional design of the study does not provide conclusive evidence for a cause-effect relationship and only allows for the conservative prognosis that a greater degree of motor impairment may cause a greater degree of peer problems and thus a greater degree of internalizing/externalizing problems. Nevertheless, the results of this study emphasize the importance of being well-integrated in their peer group especially for children with developmental coordination disorder.

Systematic review on measurement properties of questionnaires assessing the neighbourhood environment in the context of youth physical activity behaviour

BackgroundHigh-quality measurement instruments for assessing the neighbourhood environment are a prerequisite for identifying associations between the neighbourhood environment and a person’s physical activity. The aim of this systematic review was to identify reliable and valid questionnaires assessing neighbourhood environmental attributes in the context of physical activity behaviours in children and adolescents. In addition, current gaps and best practice models in instrumentation and their evaluation are discussed.MethodsWe conducted a systematic literature search using six databases (Web of Science, Medline, TRID, SportDISCUS, PsycARTICLES and PsycINFO). Two independent reviewers screened the identified English-language peer-reviewed journal articles. Only studies examining the measurement properties of self- or proxy-report questionnaires on any aspects of the neighbourhood environment in children and adolescents aged 3 to 18 years were included. The methodological quality of the included studies was assessed using the COSMIN checklists.ResultsWe identified 13 questionnaires on attributes of the neighbourhood environment. Most of these studies were conducted in the United States (n = 7). Eight studies evaluated self-report measures, two studies evaluated parent-report measures and three studies included both administration types. While eight studies had poor methodological quality, we identified three questionnaires with substantial test-retest reliability and two questionnaires with acceptable convergent validity based on sufficient evidential basis.ConclusionsBased on the results of this review, we recommend that cross-culturally adapted questionnaires should be used and that existing questionnaires should be evaluated especially in diverse samples and in countries other than the United States. Further, high-quality studies on measurement properties should be promoted and measurement models (formative vs. reflexive) should be specified to ensure that appropriate methods for psychometric testing are applied in future studies.

Prediction of attendance at fitness center: a comparison between the theory of planned behavior, the social cognitive theory, and the physical activity maintenance theory

In the processes of physical activity (PA) maintenance specific predictors are effective, which differ from other stages of PA development. Recently, Physical Activity Maintenance Theory (PAMT) was specifically developed for prediction of PA maintenance. The aim of the present study was to evaluate the predictability of the future behavior by the PAMT and compare it with the Theory of Planned Behavior (TPB) and Social Cognitive Theory (SCT). Participation rate in a fitness center was observed for 101 college students (53 female) aged between 19 and 32 years (M = 23.6; SD = 2.9) over 20 weeks using a magnetic card. In order to predict the pattern of participation TPB, SCT and PAMT were used. A latent class zero-inflated Poisson growth curve analysis identified two participation patterns: regular attenders and intermittent exercisers. SCT showed the highest predictive power followed by PAMT and TPB. Impeding aspects as life stress and barriers were the strongest predictors suggesting that overcoming barriers might be an important aspect for working out on a regular basis. Self-efficacy, perceived behavioral control, and social support could also significantly differentiate between the participation patterns.

Validity and reliability of a self-report instrument to assess social support and physical environmental correlates of physical activity in adolescents

BackgroundThe purpose of this study was to examine the internal consistency, test-retest reliability, construct validity and predictive validity of a new German self-report instrument to assess the influence of social support and the physical environment on physical activity in adolescents.MethodsBased on theoretical consideration, the short scales on social support and physical environment were developed and cross-validated in two independent study samples of 9 to 17 year-old girls and boys. The longitudinal sample of Study I (n = 196) was recruited from a German comprehensive school, and subjects in this study completed the questionnaire twice with a between-test interval of seven days. Cronbach’s alphas were computed to determine the internal consistency of the factors. Test-retest reliability of the latent factors was assessed using intra-class coefficients. Factorial validity of the scales was assessed using principle components analysis. Construct validity was determined using a cross-validation technique by performing confirmatory factor analysis with the independent nationwide cross-sectional sample of Study II (n = 430). Correlations between factors and three measures of physical activity (objectively measured moderate-to-vigorous physical activity (MVPA), self-reported habitual MVPA and self-reported recent MVPA) were calculated to determine the predictive validity of the instrument.ResultsConstruct validity of the social support scale (two factors: parental support and peer support) and the physical environment scale (four factors: convenience, public recreation facilities, safety and private sport providers) was shown. Both scales had moderate test-retest reliability. The factors of the social support scale also had good internal consistency and predictive validity. Internal consistency and predictive validity of the physical environment scale were low to acceptable.ConclusionsThe results of this study indicate moderate to good reliability and construct validity of the social support scale and physical environment scale. Predictive validity was only confirmed for the social support scale but not for the physical environment scale. Hence, it remains unclear if a person’s physical environment has a direct or an indirect effect on physical activity behavior or a moderation function.

Zum Zusammenhang zwischen körperlicher Aktivität und Gesundheit bei Kindern und Jugendlichen

ZusammenfassungAufgrund des zunehmend diskutierten Gesundheitszustandes von Kindern und Jugendlichen sowie der veränderten Bewegungswelt ist die Frage nach der Wirkung körperlicher Aktivität auf Gesundheitsaspekte von großer Bedeutung. Der Kinder- und Jugendgesundheitssurvey (KiGGS) des Robert Koch-Instituts liefert erstmals bundesweit repräsentative Querschnittdaten zum Zusammenhang zwischen Gesundheit und körperlicher Aktivität. Unter Berücksichtigung soziodemografischer Faktoren legen die Ergebnisse einen positiven Zusammenhang zwischen allgemeinem Gesundheitszustand und verschiedenen Arten der körperlichen Aktivität nahe. Die Ergebnisse variieren dabei hinsichtlich Geschlecht und Art der körperlichen Betätigung. Kausale Rückschlüsse sind aus methodischen Gründen erst nach dem Vorliegen längsschnittlicher Verlaufsdaten und damit nach der zweiten Welle des KiGGS möglich.AbstractThe question of whether physical activity is associated with positive aspects of health becomes increasingly more important in the light of the health status in today’s children and adolescents and due to the changing lifestyle with respect to everyday activity. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected the first set of nationwide representative cross-sectional data to examine the relationship between health and physical activity. Taking sociodemographic parameters into consideration, the results suggest a positive association between self-estimated general health and several types of physical activity. The results vary with respect to gender and type of physical activity. For methodological reasons, causal conclusions can only be drawn after longitudinal data of the second wave of KiGGS are available.The question of whether physical activity is associated with positive aspects of health becomes increasingly more important in the light of the health status in todays children and adolescents and due to the changing lifestyle with respect to everyday activity. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected the first set of nationwide representative cross-sectional data to examine the relationship between health and physical activity. Taking sociodemographic parameters into consideration, the results suggest a positive association between self-estimated general health and several types of physical activity. The results vary with respect to gender and type of physical activity. For methodological reasons, causal conclusions can only be drawn after longitudinal data of the second wave of KiGGS are available.

Nutzen von sportlicher Aktivität im Erwachsenenalter : eine Längsschnittstudie über 10 Jahre

ZusammenfassungDer Beitrag beschäftigt sich mit der Frage, welchen langfristigen Nutzen sportliche Aktivität im Erwachsenenalter auf die körperliche Leistungsfähigkeit und den subjektiven sowie objektiven Gesundheitszustand haben kann. Sind Personen, die regelmäßig und durchgehend Sport treiben, gesünder und fitter als die jenigen, die erst später mit der sportlichen Aktivität beginnen, oder als die jenigen, die nie sportlich aktiv waren? Die Ergebnisse der vorgestellten Längsschnittstudie über 10 Jahre mit Personen im mittleren und späteren Erwachsenenalter zeigen, dass sich körperliche Leistungsfähigkeit und subjektive Gesundheit in der Gesamtstichprobe über 10 Jahre verschlechtern, dass es aber positive Effekte von sportlicher Aktivität gibt. Diese zeigen sich in einem verlangsamten Abbau. Die durchgängigen Sportler profitieren hierbei am stärksten, aber auch ein späterer Einstieg kann körperliche Leistungsfähigkeit und Gesundheit verbessern bzw. stabilisieren. Früheres Sporttreiben ist jedoch keine Garantie für lebenslange Fitness und Gesundheit. Die Gruppe der Abbrecher verzeichnet in beiden Variablen nach dem Sportausstieg große Verschlechterungen.AbstractThis article deals with the question of which longitudinal effect physical activity at the adult age can have on physical fitness and on people’s subjective as well as objective state of health. Are persons who are regularly and continuously physically active healthier and fitter than people beginning physical activity at a later age, or than those who have never been physically active at all? The results of the presented longitudinal study, run over a time range of 10 years, with subjects at the middle and later adult age, show that on average physical fitness and subjective health decline with in the analysed time range, but positive effects of physical activity do exist. These show up in a decelerated decline. The constant sportsmen benefit most here, but also a late start with physical activity can improve and stabilize physical fitness and health. Anyway, former physical activity is no guarantee for lifelong fitness and health. The group of the dropouts registers large degradations in both variables after quitting physical activity.

Prevalence and socio-demographic correlates of active commuting to school in a nationwide representative sample of German adolescents.

OBJECTIVE To assess the prevalence and socio-demographic correlates of walking and cycling to school in a nationwide representative cross-sectional sample of German adolescents. METHODS A sample of 1828 German adolescents aged 11-17 years were examined between 2003 and 2006. Mode of commuting to school was assessed using a reliable self-report measure. Socioeconomic status, migration background and residential area were assessed as socio-demographic variables using a parent-report questionnaire. RESULTS Overall, 19.4% of adolescents walked and 22.2% cycled to school. Compared to girls with high socioeconomic status, girls with low socioeconomic status were more likely to walk (OR = 1.89, 95% CI = 1.23-2.89). Migration background increased the chance of walking in girls (OR = 0.47, 95% CI = 0.32-0.70) and decreased the chance of cycling in boys (OR = 2.39, 95% CI = 1.35-4.24). Compared to living in cities, living in rural areas lowered the chance of walking (girls: OR = 0.29, 95% CI = 0.18-0.50; boys: OR = 0.54, 95% CI = 0.32-0.93) and cycling (girls: OR = 0.12, 95% CI = 0.06-0.24; boys: OR = 0.34, 95% CI = 0.21-0.56), and living in medium-sized towns increased the chance of cycling in girls (OR = 1.86, 95% CI = 1.24-2.78) and boys (OR = 1.75, 95% CI = 1.20-2.56), respectively. CONCLUSIONS In Germany many adolescents use motorised transportation. Socio-demographic variables were associated with mode of commuting.

Elaboration of the Environmental Stress Hypothesis–Results from a Population-Based 6-Year Follow-Up

The aim of this paper was to contribute to the elaboration of the Environmental Stress Hypothesis framework by testing eight hypotheses addressing the direct impact of gross motor coordination problems in elementary-school on selected physical, behavioral and psychosocial outcomes in adolescence. Results are based on a longitudinal sample of 940 participants who were (i) recruited as part of a population-based representative survey on health, physical fitness and physical activity in childhood and adolescence, (ii) assessed twice within 6 years, between the ages of 6 and 10 years old as well as between the ages of 12 and 16 years old (Response Rate: 55.9%) and (iii) classified as having gross motor coordination problems (N = 115) or having no gross motor coordination problems (N = 825) at baseline. Motor tests from the Körperkoordinationstest, measures of weight and height, a validated physical activity questionnaire as well as the Strength and Difficulties Questionnaire were conducted. Data were analyzed by use of binary logistic regressions. Results indicated that elementary-school children with gross motor coordination problems show a higher risk of persistent gross motor coordination problems (OR = 7.99, p < 0.001), avoiding organized physical activities (OR = 1.53, p < 0.05), an elevated body mass (OR = 1.78, p < 0.05), bonding with sedentary peers (OR = 1.84, p < 0.01) as well as emotional (OR = 1.73, p < 0.05) and conduct (OR = 1.79, p < 0.05) problems in adolescence in comparison to elementary-school children without gross motor coordination problems. However, elementary-school children with gross motor coordination problems did not show a significantly higher risk of peer problems (OR = 1.35, p = 0.164) or diminished prosocial behavior (OR = 1.90, p = 0.168) in adolescence, respectively in comparison to elementary-school children without gross motor coordination problems. This study is the first to provide population-based longitudinal data ranging from childhood to adolescence in the context of the Environmental Stress Hypothesis which can be considered a substantial methodological progress. In summary, gross motor coordination problems represent a serious issue for a healthy transition from childhood to adolescence which substantiates respective early movement interventions.